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General NPI Number Information
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NPI Number | 1194720284
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Entity Type | Individual
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Provider Name | GREGORY J CERILLI MD
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Gender | Male
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Dates
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Enumeration Date | 06/16/2005
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Last Update Date | 07/21/2022
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Provider Practice Location Address
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Address Line | 5301 E. HURON RIVER DR.
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City | YPSILANTI
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State | MI
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Zip | 48197
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Country | US
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Telephone | 734-712-7017
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Fax | 734-712-2844
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Provider Business Mailing Address
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Address Line | PO BOX 0446 24 FRANK LLOYD WRIGHT DR. LOBBY J
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City | ANN ARBOR
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State | MI
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Zip | 48106
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Country | US
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Telephone | 419-291-5150
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Fax | 419-479-6173
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208600000X
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Taxonomy Name | Surgery Physician
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License Number | 35069105
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License Number State | OH
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Taxonomy #2
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Taxonomy Code | 2086S0127X
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Taxonomy Name | Trauma Surgery Physician
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License Number | 4301104239
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License Number State | MI
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Taxonomy #3
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Taxonomy Code | 2086S0102X
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Taxonomy Name | Surgical Critical Care Physician
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License Number | 4301104239
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License Number State | MI
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